SAN DIMAS PERIODONTICS
NPI 1033261391
Dentist - Periodontics in San Dimas, CA

Q: What is San Dimas Periodontics's NPI number?

The NPI number for San Dimas Periodontics is 1033261391. It was assigned to this organization in the NPPES registry on January 17, 2007.

Q: What is San Dimas Periodontics's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Active since January 17, 2007

1111 W COVINA BLVD STE 220, SAN DIMAS, CA 91773(909) 599-9510(909) 599-1610 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About San Dimas Periodontics NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAN DIMAS PERIODONTICS (NPI 1033261391) is a healthcare organization registered as a periodontics in San Dimas, California and active in the NPI registry since January 2007. The organization lists Mohamed Ihsan Kayali, President, as its authorized official.

NPPES Registry Identity

NPI1033261391

Entity TypeOrganization

Primary Taxonomy1223P0300X

Legal Business NameSAN DIMAS PERIODONTICS

Location Address1111 W COVINA BLVD STE 220San Dimas, CA 91773-3205

Mailing Address1111 W Covina Blvd Ste 220San Dimas, CA 91773-3205 · (909) 599-9510 · Fax (909) 599-1610

Phone(909) 599-9510

Fax(909) 599-1610

Organization SubpartNo

Authorized OfficialMohamed Ihsan KayaliPresident · (909) 599-9510

Enumeration DateJanuary 17, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1033261391 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

License✔ Licensed in CA · 44495

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

1111 W COVINA BLVD STE 220, San Dimas, CA 91773

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is San Dimas Periodontics's NPI number?

The NPI number for San Dimas Periodontics is 1033261391. It was assigned to this organization in the NPPES registry on January 17, 2007.

Where is San Dimas Periodontics located?

San Dimas Periodontics is located at 1111 W Covina Blvd Ste 220, San Dimas, CA 91773. The listed phone number is (909) 599-9510.

What is San Dimas Periodontics's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

What insurance does San Dimas Periodontics accept?

Health plans from UnitedHealthcare list San Dimas Periodontics as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for San Dimas Periodontics was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.